The latest assault on the NHS involves the imposition of a new contract for junior doctors that will see their salaries slashed by 30%, with a requirement for evening and Saturday work.

The excuse used to justify this change is to provide a seven-day service and improve patient outcomes on weekends.

The reality is that more qualified staff are being driven out in preparation for the de-skilling that is always part of healthcare privatisation and corporate takeover. For the UK, this is mapped out in the Five Year Forward View by Simon Stevens, the head of NHS England. Stevens used to be an executive of the US based private health care company, UnitedHealth.

What all junior doctors – and the rest of us – need to know

Many junior medics – which means all doctors not yet senior enough to work in consultant positions – have been stirred into action, but it is crucial for them to understand the context of their current predicament to mount an effective campaign to protect patients, restore decent treatment of staff and block the completion of the privatisation of the NHS.

But first, a little history lesson…

Conversion from the NHS model, a publicly funded, provided and universal system, to a private insurance model has been proposed for decades.

In 1968 Arthur Seldon, later Margaret Thatcher’s privatisation policy adviser, produced a pamphlet for the Institute of Economic Affairs called After the NHS, explaining the aspiration to “improve the NHS” by abolishing it, so as to build profit opportunities for the insurance industry.

Further incarnations of this plan to enable the insurance industry to increase its profits in the UK by destroying the NHS surfaced in the 1980s. These included Health of Nations by the Adam Smith Institute and, in 1988, Britain’s Biggest Enterprise: Ideas for Radical Reform of the NHS. The latter was the vision of current Conservative Minister of State for Government Policy, Oliver Letwin MP, in the NHS privatisation manifesto he authored with John Redwood MP, published by the Centre for Policy Studies, a Thatcherite think-tank.

The stealth privatisation of the NHS had quietly begun under the Thatcher administration and has continued unabated ever since. The sole attempt to bring the plan out of the shadows, its presentation to a Conservative cabinet in 1983, was so roundly rejected that the decision was taken to complete the privatisation by covert means, under a series of false narratives to distract the public from what was really going on.

This has involved a number of seemingly disparate measures, from the outsourcing of non-clinical services, to the introduction of market bureaucracy, splitting up of the hospital network into independent Trusts and the usurious Private Finance Initiative (PFI) scheme, designed to create an opportunity to gouge the public purse through inflating the costs of funding new hospital building. Started on John Major’s watch, PFI continued under Tony Blair and Gordon Brown.

Indeed, Blair’s New Labour government enthusiastically continued with the privatisation project, while maintaining the deceptions contained within successive pointless top-down reorganisations. hese actually took the NHS further down the privatisation road, precisely following the steps laid out in the Health of Nations NHS privatisation plan.

Why the hell didn’t we know about this?

Consecutive governments have diligently obscured the intent of health reforms with spin and misdirection, while senior NHS positions have often been filled by those who would not be likely to point out these lies to their medical colleagues and the public. The success of the project depended on public ignorance and distracting attention with myth creation. The propaganda agents include large sections of the media, in particular the BBC. Our public service broadcaster has avoided scrutinising health reforms and instead simply regurgitates government spin, peddles myths and presents pro-privatisation think tanks as if they were independent.

In contrast, growing public and professional protest has been conveniently ignored. It is censorship by omission.

The British Medical Association (BMA) has spent the last two decades gently nodding through marketisation and privatisation under the guise of ‘critical engagement’. They have provided no effective challenge to government policy, and kept members in the dark to a degree that could suggest complicity at leadership level. Genuine opposition by BMA leaders to the Health and Social Care Act 2012 could have prevented the NHS being carved up for profiteers for example.

What state is the NHS in now?

The NHS has been fundamentally transformed in the last 20 years. Our nationally integrated hospital network has been split up into distinct business units (“foundation trusts”), which were deliberately burdened with PFI millstones which would throw them into insolvency as soon as a funding squeeze was applied to trigger this at the right time for privatisation….

I got given Thorazine today which basically cleared out half of the old school mental asylum patients in the 50s, it was the first psychiatric drug and I thought it wasn't really used anymore, it's like a fuckin chemical smack in the head so you sit back down again, yet I've been begging for something safe and modern for 18 months, so the NHS is fucked from where I'm standing, appreciating what the voluntary sector does a lot more. But I'll have to read that long post and read up from last week, the latest stories so I'm still in the fuck 'em camp based on my knowledge up to now.

Sid wrote:How would it be better private? How would it be better if you couldn't afford medical bills? You wouldn't even be getting this treatment.

It's not a case of which is better, private or national healthcare. There's no option for us because we're fucking skint

Google how much the treatment you've had so far would cost if you went private. It's fucking hilarious.

It would be much better private but IF you had a load of cash. That's the bottom line. That's why the NHS is a great leveller and a superb concept. The fact that it does so well for people who DON'T have loads of cash is why it is the shining light for the idea of trying to be fucking fair in this world. Problem is that this fucking world ain't fair and the only real surprise is that such a beacon of fairness has lasted so long.

Thing is other countries have free healthcare as well. It's a staple of rich countries bar America. We're told to be grateful to have it, that it's barely affordable, that we're so lucky to have it. But is it fuck. We pay for it and we have enough money to fund it. 5th richest economy in the world. But there's this belief now that it's a luxury we can't afford, and it's all part of manipulating the discourse so they can privatise it

Sid wrote:How would it be better private? How would it be better if you couldn't afford medical bills? You wouldn't even be getting this treatment.

It's not a case of which is better, private or national healthcare. There's no option for us because we're fucking skint

Google how much the treatment you've had so far would cost if you went private. It's fucking hilarious.

Did I say it would be better private? It might as fuckin well be semi private for fuck sake because the treatment you get and what you pay depends on where you live, am I lucky because I get free prescriptions? Yeah! Has it been a waste of GPs time and resources that for TWO years ive been getting medication that does fuck all because it's easier for them to write a prescription for shit without treating the problem, all I've ever wanted was a referral to someone to get a diagnosis for a specific illness, that's it, no pills, no 30 apts come back in two weeks thanks, take the cost of all the medication, add it up, then flush it down the bog BECAUSE ITS WHAT THEY ARE TOLD TO DO, NOT WHATS RIGHT FOR THE PATIENT, thousands of pounds wasted, I got told at the very start of January, how about we put you on a course of something else for two months then you can come back because they don't really like us referring people for diagnosis because they are really busy, in other words, fuck off and push that under the pile for the meantime, I dug my heels in, got my referral, went again yesterday because I hadn't even had a letter to say I was on the list, yip referred urgent 5th January, not even a note to me. One condition. Dealing with 5 different services, nobody knows who's funding who, everyone is passing the buck and round we go. If it was run properly, all those letters, drugs, referrals, all different services, wouldn't have been needed, two years, could be fuckin twenty grand wasted, fuck knows how much time each new organisation needs to register you, call each patient, put them in a queue, monitor the queues. So much red tape it's a fuckin mess. Maybe three max GP visits a year and half a go and one referral and they'd hopefully never have to spend much time on me again until I retire, that's one patient. How much is being wasted that we could pay all staff what they deserve and have a streamlined public service.

America is private, I get that, but when I've been looking up stuff and reviewing forums, there are hardly any brits because they go for their 5 minute appointment in three weeks time, get what ever latest safe cheap drug nice has approved which the GP has just looked up online and get a print out prescription. The American ones are like, well we talked about things for 20 minutes, I got a prescription that my GP personally felt was best then my GP called after a week and said they were going to run another course of treatment past a specialist and if they ok'd it, we'll try that and I'll call you in two weeks.

I know that's not always going to be the case but the complete lack of bed side manner here and the absolute almost salivating impulse that GPs here have and I'm talking 7 or 8 I've seen to just get the blue book out, click the computer, and that's the medicine you get, might as well go in and go through a self assessment print off prescription as long as it's a safe generic well tolerated drug.

Yet as I leave the surgery there is a plethora of posters asking you to contact your GP relating to the issue in question and about 20 fuckin bill boards in the city centre about it, fuck knows how many hundreds of thousands on radio tv and magazine and newspaper ads, it makes me sick.

Anyway, I didn't mention private, just put cunts in to run the thing properly

No balls like the old Doctors, will not make a decision or prescribe something serious, my mum is disabled and it took a hospital Doctor to prescribe the medication she needed which I called about 3 years ago, I butted out, low and behold she doesn't even need to see a GP now, because the hospital clearly knew it was medicine 101, now the GPs just sign the repeats like good little lap dogs, one in December wouldn't even prescribe me a cough bottle when I was fucked with a chest infection. Cunts!

I'm not an expert but I know a bit, I worked in a pharmacy and was in the health insurance industry and set up my own cheap medical screening company to make it affordable for the average punter, I don't know how many people have told me what they had, how they did/didn't recover, what drugs they were on, so I've a fair idea when I'm been bullshitted to. Sure Omeprazole, many of you on that, heard of it, they've been knocking it out like candy here for anyone that complains of any stomach problems, I mean I know about 12 cunts on it, it's just been pulled because of a link to cancer,